Home' Australian Ageing Agenda : AAA Nov-Dec 2016 Contents Community Care Review is Australia's
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Preparing for Feb 2017
Understanding best practice
The power of pets
Fo r success with CDC o n the business side, McKech nie
unders cores the i mporta nce of paying attent ion to the b usiness
met rics involved in i ndividualis ed bud gets.
"It's critical for service providers that, in the drive to appear
efficient and competitive in the value for money proposition, they
don't actually undersell or fail to recognise some of the costs
associated with their service delivery.
"So we have put time and effort into making sure that all our
pricing is fair but also sustainable."
Since embarking on its CDC journey, McKechnie says Resthaven
hasn't necessarily seen a dramatic shift in the kinds of services people
want, but rather a shift in how and when these services are delivered.
This has meant that staffing arrangements have had to become
somewhat more flexible in response. "It is a great credit to our staff that
they have been engaged with the processes and been willing to change.
SUPPORTING CLIENTS TO TAKE CHARGE
McKechnie says clients are responding positively to opportunities
to have a greater role and say in how their care and services are
delivered. "They feel much more comfortable about being in the
Looking to the future, McKechnie says there is no doubt
Resthaven will continue to learn more about overall client
preferences and the different kinds of service options they would
like to see available.
"We can make most servic es available to people; th rough
outsourcing, we can find all sorts o f things. The challe nge for
us is to see whether fo r some of those serv ice s ther e's sufficien t
common ality that makes it worthwhi le to de vel op as a service
op tion that's directly availa ble thro ugh Re sthaven," she sa ys.
Resthaven is committed to
continuous quality improvement, and
in that regard it will look to benchmark
information to understand opportunities
for growth, and continue to use consumer
engagement strategies to understand
However, among the immediate
challenges facing all community
care providers is the uncertainty that
accompanies the planned deregulation of
the sector in 2017, says McKechnie.
Providers need to be prepared for the
"ebbs and flows" that will inevitably come
with a less predictable level of service
and increased competition. However, she
says while posing new risks the reforms
commencing in February also provide
significant opportunities for growth. n
with clients. This was particularly important with more experienced
staff who "carried the rulebook in their head", says McKechnie.
"There are very traditional ways of delivering services which
always make the assumption that the service provider is the expert.
What we were having staff work through is the idea that people are
experts in their own life and what works for them.
"That doesn't diminish the role of the service co-coordinator,
but it changes it -- to be much more about helping people achieve
what they want to achieve, rather than the service provider taking a
considered view about what would be best."
One early challenge was getting staff to trust in older people to
make sound decisions for themselves, says McKechnie.
This is a universal issue for th e sector, she s ays, n oting the
most common types of questio ns raised at industry forums on
CDC and co-de sig n continue to concern provider r esp onsibility
and duty of ca re.
"When we see family members who are being very cautious or
restrictive, we'll describe them as being overprotective. But then
when service providers do exactly the same thing, they tend to call
it duty of care."
McKechnie points to the notion of dignity of risk, and says staff
must facilitate their clients having autonomy over their lives, and
respect that they are capable of learning new things and defining
their aspirations, regardless of limitations or age.
"It is about giving people the room to move, and accepting that
people will modify their decisions over time if they learn that they
need to adjust them. Otherwise, the potential is you're placing
barriers or unnecessary safeguards around people."
McKechnie says Resthaven has also spen t time working with
staff to und erscore that as the marketplace becomes increasingly
competitive customer ser vice w ill bec ome more imp o rt ant than
ev er b efore.
"When it comes to customer service, the details matter," she
says. This means finding out from clients not only what they would
like, but how they want it delivered. It's about following through on
what is promised, and that changes to delivery -- such as a different
staff member -- are clearly communicated.
advisory groups to te st and s implify its
CDCsystemsfor ease ofuse.Thishas
led to mor e plain English ve rsi ons of
agreements and simp ler and e asie r t o
fol low client budge t statements, that
are al so easie r for tra nslat ion purposes
when working wit h pe ople of diverse
cultur al b ac kgroun ds.
Resthaven are aged care specialists with an 80-year history
in South Australia. The organisation has had a 25-year
involvement in community services and provided support to
8,000 clients last financial year.
Phone: (08) 8373 9000, Email: email@example.com
A SPECIAL RETREAT
THE SHED at Hersey Respite Cottage, run through
Resthaven Community Respite Services, continues to grow
The popular program recently moved into a new, larger
shed area, to the delight of participants.
Projects the groups have been involved in include
propagating plants for Trees for Life, and making raised
garden beds from recycled pallets, donated by a local carpet
store, amongst many others.
"The program is continually growing, with more members
joining all the time," says Manager of Community Respite
Services, Carole Matthews.
"To meet demand, we recently increased the program to
four days a week.
"This is a great program, which really benefits people. We
look forward to continuing it into the future."
In another community initiative, Resthaven has been
working with the University of Queensland to improve
the social connection of remotely located clients in
the Riverland. As part of the Commonwealth-funded
Community Visitors Scheme, clients are being taught
how to use an iPad to open up a whole new world of
communication and engagement.
since 2012. The p j
of CDC. These cost profiles, how clients are deploying their
funds, as well as the impact of CDC on quality of life.
A second project is also underway with the University of
South Australia looking at the broader aspects of choice and
what it means for older people.
Sue McKechnie, Executive Manager of Community
Services, says it's important for Resthaven to be connected
to research as it adds a strength and rigour to practice.
"It adds an evidence base, the opportunity for us to
explore international trends, and contribute to the growing
international body of understanding in relation to co-
production, consumer choice, quality and how that applies
to services for older people," she says.
GETTING CREATIVE: CLIENTS, VOLUNTEERS JOIN IN COMMUNITY ARTS PROJECT
EARLIE R T HIS year art teacher
and visual artist John Whi tney was
commissioned by Resth aven to create
a mural for Resthaven Northern
Community Serv i ces.
The mural, which was finished at the
V-TECH workshop at Davoren Park, was
installed on the exter ior wa ll of the site
in early August.
Mr Whitney had a ble assistance
from four young c ommunity volunteers ,
Bianca, Lauchla n, Cam eron and Dylan
a long with Violet James, to complete
the m u ral---a won derful display of
int ergenerational coll aboration and
l earning. Resthaven s taff also lent a
hand on the artwork.
RegHall andHome SupportWorker, Ian, hardat work.
aaa community care review | 25
24 | AUGUST 2016
self-assessment tool, which allows clients to either login via a secure
portal or work with a service co-ordinator to assess their abilities to
be independent and their needs for support and clinical care.
From this assessment, staff explore with client s what's
important to them and what difference the y expect Re sthaven to
make i n thei r lives.
"By having them reflect on their own situation, we find people
tell us a lot more information about how they go about things, what
their aspirations are, what help they have from family members and
what other services they're accessing. From this, we can really help
them define what it is that would make a difference to them."
McKechn ie s ay s this mode l moves a way from a tradi tional
se rvi ce approa ch in which s taff offer c lie n ts a "menu" of serv ices
t o pick from. Inste ad, staff work with clients to f ac i litat e, wit h in
their i n dividualis ed budget, whatever works best for them.
Co-design of services has been important to Resthaven even
before CDC was legislated. The organisation ran its own internal
pilot of a consumer directed model some years ago after noticing
co-design philosophies emerge overseas.
The feedback and findings from Resthaven's trial, as well as
those from other providers, were a catalyst in encouraging the
government's own national CDC pilot in 2010, says McKechnie.
Resthaven also participated in that trial, which allowed it to
develop and finesse its approach even further.
"The benefit of all that preliminary work was that we learnt very
early on that the key to success with a consumer directed model is
actually about culture change, and learning
for our staff," she says.
Indeed, one of the key industry issues
that McKechnie has seen since the rollout
of CDC is that many providers are caught
up in the technical changes associated with
handling individualised budget funds rather
than investing in a new way of working.
"There's a tension that has been created
between change processe s associated
withbusiness systems andthe change
proce sses as sociated around a positive
culture change to m aking CDC really work
for p eople," she sa ys.
"So we're pleased that we had the
opportunity to spend a lot more time
understanding the extent of the culture
change, and working positively through
that with our teams to skill people to
ADAPTING FOR SUCCESS
To achieve successful culture change under
CDC, McKechnie says providers need to
look at the foundation principles of their
organisation and see how they work with or
need to be adapted under the model.
As part of its own change journey,
Resthaven spent a lot of time working
closely with staff to explore and challenge
their value sets about service delivery.
Training focused on role play and
helping staff to change the "script" they
worked to in their everyday conversations
Community aged care providers are facing a time of great
change, with many continuing to wrestle with the practical
aspects of ongoing reform to the sector.
While noting the challenges, South Australian provider Resthaven,
which has operated in community services for 25 years and provides
support to around 8,000 clients, is embracing the change.
The organisation supports that consumer directe d care has
encour aged and facilitated older people's grea ter involvement in
the design of their own services , seeing it consistent with its own
approach to ser vices, b u ilding on the self-mana gement principles
and personal control elements that plans of care had encoura ged
in the past.
Resthaven adopts an integrated
se rvice a p p roach, which seeks to promote
wellbeing, independence and autonomy
for clients , so they can remain positively
engaged with their life, aspirations and
social contact s.
One way this works is by allowing older
people to undertake a self-assessment
of their own situation and service needs,
says Resthaven's Executive Manager of
Community Services Sue McKechnie.
Resthaven has developed its own client
Sue Mc Kech nie,
C om mun ity Services
way on CDC
A s an industry leader and early adopter of consumer dir ected care , Resthaven
has been on a n extensive jo urn e y to embed an organisatio nal cu l ture th at
supp or ts client a utonomy and de cision-makin g.
Frank William s wi th
Er ic Lillie, who is pa rt of
a c arer res pite grou p,
Home Support Wo rker
"Th e benefi t of all the preliminar y wo rk
was that we learnt very early on that
the key to success with a consumer
directed model is actually about c ulture
change, and learning for our staff."
aaa community care review | 23
22 | AUGUST 20 16
Further, evidence continually shows
that older Australians would prefer to age
Such is the demand for home care
services, many existing aged care providers
are now diversifying into this area.
However, the lack of affordable
downsizing options located in established
neighbourhoods is also an issue. New
aged care homes and retirement villages
tend to be built in fringe suburbs where
land is relatively affordable, requiring
consumers to have to move far away from
their social networks and families in order
to access them.
There is increasing potential for home
care providers and apartment developers to
form partnerships to develop infill housing
incorporating universal design principles.
This could be incentivised via
government subsidies. Such an approach
has the potential to create benefits for
governments, consumers, developers and
home care service providers alike.
It would allow residents to access
affordable downsizing options in
neighbourhoods that are familiar while
also receiving home care services
based out of smaller, more distributed
administrative provider hubs.
Further, new and emerging
technologies will increasingly support
people to live at home for even longer.
We have been working on master plans
for numerous neighbourhood and major
activity centres where retirement and
aged care facilities are contained within
An example is St Germain, a new
urban development in Melbourne's outer
southeastern suburbs, where a new hybrid
retirement village and aged care facility will
be located directly opposite the town centre.
Increasingly, it will be organisations
that provide accommodation and services
in line with the changing attitudes and
perceptions of ageing that successfully
capitalise on the seismic societal shifts
currently underway. n
Robert Goodliffe is an architect and partner
St Germain, a new urban development, is a hybrid
retirement village and aged care facility
www.australianageingagenda.com.au | 31
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